GP quality - London: CQC ratings confirm challenge in East London

Four out of the five worst performing CCGs for primary care are in East London, according to aggregated CQC ratings

Tower Hamlets bucks the trend though with 10 per cent of all GP surgeries rated outstanding

North West London has four out of the five top CCGs with the most surgeries rated outstanding

HSJ’s analysis of Care Quality Commissioning ratings of GP surgeries shows that east London is underperforming against the rest of the capital.

We have reviewed all CQC GP inspection reports published by 1 March 2017 to reveal the number of surgeries in each clinical commissioning group area that received a rating of inadequate, requires improvement, good or outstanding.

Analysis of the London region shows that four of the worst five performing areas in the city border each other in east London.

Looking at the combined total of GP surgeries rated requires improvement and inadequate by the CQC, the data shows that almost half of all primary care providers in Havering CCG have received the bottom two CQC ratings (see table). Waltham Forest CCG is close behind with 37 per cent of surgeries rated requires improvement or inadequate.

However, Tower Hamlets significantly bucks the trend, topping the list of CCGs with the most surgeries rated outstanding, with 10 per cent of its primary care providers receiving the top rating (see second table).

Sir Sam Everington, chair of Tower Hamlets CCG, said his area deals with “massive challenges” such as a typical 30 per cent a year turnover of patients registered at practices and a 11 year life expectancy gap between the richest and poorest in the area. Sir Sam said Tower Hamlets has overcome the “added pressures” this places on GP practices by placing a “great focus on quality improvement and camaraderie”. He cited monthly protected team learning time for each GP practice, IT systems to chase patients for follow-up appointments and routine vaccinations, and a locally devised clinical effectiveness dashboard that allows doctors to view quality data in real time to drive improvement.

In contrast to the east, four of the top five CCGs rated outstanding are in north west and central London, from Westminster in central London towards Harrow on the edge of the city.

Top 10 London CCGs with the highest percentage of GP surgeries rated requires improvement or inadequate

CCG

% of GP surgeries rated requires improvement or inadequate

Havering

48.4

Waltham Forest

37.1

Barking and Dagenham

34.5

Southwark

29.4

Newham

28.6

Hammersmith and Fulham

25.0

Redbridge

25.0

Sutton

23.8

Barnet

23.5

Greenwich

23.3

London CCGs with the highest percentage of GP surgeries rated outstanding

CCG

% of GP surgeries rated outstanding

Tower Hamlets

10.3

Central London (Westminster)

7.4

West London (Kensington and Chelsea, Queen’s Park and Paddington)

4.3

Harrow

4.2

Lambeth

2.8

Lewisham

2.7

Bromley

2.5

Newham

2.4

Ealing

1.4

The rest of London’s CCGs had no surgeries rated outstanding

HSJanalysed 6,476 GP practice inspections across England out of a total of 7,705 inspected by the CQC, which accounts for 84 per cent of all surgeries. The regulator is still to publish the remainder of its GP inspection reports. It is the first time GP practices across the country have been comprehensively inspected and rated.

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